SYLLABUS
GS-2: Government policies and interventions for development in various sectors and issues arising out of their design and implementation; Issues relating to development and management of Social Sector/Services relating to Health.
Context: West Bengal is set to become the 36th State/UT to implement the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), marking a significant step towards universal health coverage in India.
More on the News
- The National Health Authority (NHA) and the Government of West Bengal will sign a Memorandum of Understanding (MoU) for the implementation of AB PM-JAY, bringing the State under the ambit of the world’s largest publicly funded health assurance scheme.
- With the signing of the MoU, West Bengal will become the 36th State/UT in the country to implement the scheme.
- The inclusion of West Bengal is expected to provide financial protection against catastrophic health expenditure to millions of eligible beneficiaries and ensure portability of healthcare benefits across India.
- The move will strengthen the State’s healthcare ecosystem by improving access to affordable and quality healthcare services through a network of empanelled public and private hospitals.
About Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY)
- AB PM-JAY is a Centrally Sponsored Scheme under the Ayushman Bharat Mission, anchored by the Ministry of Health and Family Welfare.
- The National Health Authority (NHA) is the apex body responsible for implementing the scheme.
- It was launched on 23 September 2018 at Ranchi, Jharkhand, by Prime Minister Narendra Modi.
- It is regarded as the world’s largest publicly funded health assurance scheme.
- The scheme supports about 15 crore poor and vulnerable families and around 55 crore beneficiaries.
- Components of Ayushman Bharat
- Health and Wellness Centres (HWCs): Provide comprehensive primary healthcare services closer to people’s homes. Cover maternal and child health, communicable and non-communicable diseases, mental health, dental care, eye care and geriatric care.
- Pradhan Mantri Jan Arogya Yojana (PM-JAY): Provides health insurance coverage for secondary and tertiary care hospitalization.
- Key Features:
- Provides health cover of ₹5 lakh per family per year for hospitalization.
- Covers pre-existing diseases from day one.
- Includes 3 days of pre-hospitalisation and 15 days of post-hospitalisationexpenses.
- Offers cashless and paperless treatment at empanelled hospitals.
- Benefits are portable across India.
- No cap on family size or age for eligible beneficiaries.
- Funding Pattern:
- General States: Centre (60): State (40).
- North-Eastern and Himalayan States: Centre (90): State (10).
- Eligibility: Covers poor and vulnerable families identified through the SECC database.
- Includes rural and urban deprived occupational categories.
- Covers all ASHA, Anganwadi Workers (AWWs) and Anganwadi Helpers (AWHs) and their families.
- Senior Citizen Expansion (2024): All citizens aged 70 years and above receive coverage regardless of socio-economic status.
- Eligible senior citizens receive a distinct PM-JAY card.
- Senior citizens already covered under PM-JAY families get an additional top-up cover of ₹5 lakh annually, separate from the family’s existing cover.
- Beneficiaries under Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), and Ayushman Central Armed Police Force (CAPF) can choose either their existing scheme or PM-JAY.
Significance
- Strengthens Universal Health Coverage (UHC) by expanding access to affordable healthcare.
- Reduces catastrophic health expenditure and out-of-pocket medical costs.
- Improves healthcare accessibility through a nationwide network of empanelled hospitals.
- Provides nationwide portability, allowing treatment across States.
- Enhances financial security for senior citizens through expanded coverage.
- Contributes to SDG-3 (Good Health and Well-being) and the principle of “Leave No One Behind”.
Sources:
News on Air
The Print
Economic Times
Business Standard
Vikaspedia